The present disclosure relates to methods and apparatus for the fabrication of patient-specific implants using imaging data, and more particularly relates to the fabrication of patient-specific implants for the reconstruction of defects of the skull and facial bones.
The surgical repair of a defect of the skull or facial bones can be a technically difficult, laborious and time-consuming procedure, and the accurate restoration of the missing anatomy can be particularly challenging. The recent adaptation of computer assisted design and rapid prototyping technology is known to dramatically increase efficiency and improve outcomes. Provided that the defect is stable, clearly defined and well visualized prior to surgery, computer modeling can be employed to generate a virtual 3D model of a patient-specific implant.
Titanium mesh in particular has proven to be effective clinically in the reconstruction of non load-bearing defects of the skull and facial bones (Kuttenberger and Hardt, J. CranioMaxfac. Surg., 2001; Schipper et al., Eur. Arch. Otorhinolaryngol., 2004). The mesh provides a stable, permanent, biocompatible reconstruction which is well tolerated, even when in direct contact with paranasal sinuses.
Titanium mesh is generally shaped free-hand by traditional manual forming and manipulation, or pressworking with a cavity and punch. Unfortunately, accurate restoration of missing anatomy is often difficult, and can be compromised by problems associated with forming a stable molded implant and correctly positioning the implant. This is particularly true when defects are large, involve complex contours or exist in limited access anatomical sites.